Benzoyl Peroxide

Benzoyl Peroxide (BPO) is a well-known and widely used active ingredient in acne treatments boasting a history that spans over a century, substantiated by its continued endorsement by dermatologists for acne treatments to this very day.

History

Benzoyl peroxide [BPO] was the first organic peroxide prepared in a laboratory in the early twentieth century. Its antibacterial activity was recognized but not applied in medicine initially. BPO use predates its producer. Since its synthesis it has been used also as an oxidizing agent in bleaching flour and hair, a treatment for wounds and ulcers.

Adoption in Acne Treatment

It was not long however before its antibiotic, keratolytic and comedolytic properties made it an effective treatment for acne vulgaris. Its ability to oxidize the proteins of the acne-causing bacteria Propionibacterium acnes [P. acnes] is widely known.

Over-the-Counter Availability

Initially a prescription drug, BPO was approved for over the counter [OTC] sale in various formulations. These include creams, lotions, gels, washes, and spot treatments. It was approved for OTC sale after numerous studies that have shown its safety and efficacy.

Ongoing Research and Developments

More recent studies have focused on formulation, to reduce vision and irritation which is a nearly ubiquitous side effect. Additional studies have evaluated its efficacy in improving other components of acne. Though, BPO is not a therapy that is curative. It reduces but does not eliminate P. acnes.

Molecular Structure

Benzoyl peroxide consists of two benzoyl (C₆H₅CO) groups connected by a peroxide bridge (O-O). Thanks to this inherently unstable connection, this bridge makes it easy for the molecule to morph into two powerful free radicals, which counteracts with the Cutibacterium acnes.

Antibacterial Activity

Benzoyl peroxide is not just any beauty warrior; it becomes the final boss in the fight against Cutibacterium acnes with its fleet of reactive oxygen species . These slash the bacteria in an all out oxidative attack scattering planktonic bacteria among pores.

Keratolytic Effect

BPO serves to break down the protein keratin composing much of our skin's structure. By targeting dead skin cells, it helps unclog pores and prevents comedones from forming. This keratolytic property expedites the shedding of the outer epidermal layer through peeling.

Comedolytic Action

Benzoyl peroxide. It operates as an antiseptic reducing the skin's population of the bacteria Propionibacterium acnes found at the root of acne case. It is also a serious compound that induce the shedding outer layer of the skin (epidermal peeling) and also increasing the turnover of the follicular epithelial cells which prevents the formation of inflamed acne.

Anti-inflammatory Properties

It's also a powerful tool to reduce inflammation in general. Though the exact action isn't entirely clear, it's believed that the drop in bacterial count and the reduction in fatty acids on the skin's surface both play big parts in its anti-inflammatory effects.

Oxidizing Agent

Benzol peroxide (BPO) is also an oxidizing agent: It reduces the oiliness of skin because it oxidizes the lipids of the skin surface. So it is effective in the management of the oily skin type, whose inherent oiliness leads to aikle that is prone to acne.

Effects

Antibacterial Activity

Baznoyl peroxide often make a harsh environment on skin for bacteria to survive by breaking down, and releasing oxygen radicals. These fight against certain bacteria types that don't need oxygen to survive.

Keratolytic Effect

BPO often breaks down a protein element in the skin, called keratin. It clears pores by getting rid of dead skin cells on skin, which, in return, reduces the development of clogged pores (comedones)

Comedolytic Action

BPO often helps shed the skin cells, and makes follicular epithelial cells less sticky. This helps pores function without any interruption, and consequently minimize acne formations.

Sebum Reduction

BPO is effective at making acne less sever, and improving skin texture of the skin, especially for those with oily, or acne-prone skins. It works by oxidizing surface lipids, which makes the skin less oily.

Side Effects

Skin Dryness and Peeling: BPO often interfere with skin barrier when it removes the surface layer of skin to counteract the acne-forming bacteria. This process can dry out the skin.
Redness and Irritation: A High amount of Benzoyl peroxide can cause trouble. High concentrations of Bezoyl Peroxide may help bacteria effectively, but it peels the skin. The skin barrier often reacts to this harsh process, and makes the skin more prone to irritation, and redness.
Sensitivity to Sunlight: BPO often triggers sun sensitivity, and allow more UV rays pass through the skin. This increase the chance of getting sunburnt. Sunscreen is a must if you are on BPO.
Allergic Reactions: If your skin turns red, starts itching a lot, swells, or feels irritated after using BPO, you are allergic to BPO. This is a rare case, but may happen especially for sensitive skins.
Bleaching of Hair or Fabrics: BPO often bleaches hair, or fabrics with colors. We recommend not to touch any colored fabrics with you are on BPO.

Synergy

Salicylic Acid

Salicylic acid helps acne by unclogging pores and it also prevents the formation of acne lesions, but the moderation is the key. Due to its properties that often interfere with skin barrier, it often counters acts with BPO.

Hyaluronic Acid

BPO can dry out skin, making hyaluronic acid a perfect pair for its hydrating effect. Hyaluronic acid can help maintain hydration level on skin, to fight with the dryness and peeling often related to BPO treatments.

Niacinamide

Niacinamide is known for its anti-inflammatory and skin barrier-strengthening properties, and it can help reduce the irritation and redness.

Related:Niacinamide

Ceramides

Ceramides is very effective at protecting skin barrier, and keeping skin moisture. BPO often drys out skin, which ceramides can counteract with this effect. In return, it prevents irritation, redness, and other skin issues.

Related:Ceramides

Sunscreens

Sunlight may be more harsh on skin with BPO. We recommend to pair it with a braod-spectrum sunscreen as much as possible.

Retinoids

Retinoids pairs well with BPO, especially for treating acne-prone skin. However, it should be done with caution as it can trigger skin irritations. Sensitive skin can react more severely to this pair.

Avoid With

Retinoids (Retinol, Tretinoin, Adapalene, etc.)

As mentioned above, BPO can be effective in combination with retinoids for acne-prone skins. It should be used carefully with BPO especially if you have a sensitive skin. You can apply it at different times if using both is a must.

Related:What is Retinol?

Vitamin C (Ascorbic Acid)

BPO can oxidize vitamin C, and paring both may be not the best solution. It can also trigger sensitiveness for those with sensitive skins.

AHAs and BHAs

Exfoliants with BPO can make the skin prone to sensitivity, and irritation for some people as these often interfere with skin barriers.

Alcohol-based Products

The drying effect of BPO can be exaggerated by alcohol-based products, especially to the skin barrier. Pairing these can lead to irritation, redness, and peeling of your skin.

Peptides

Certain peptides may be destabilized by benzoyl peroxide, potentially reducing their effectiveness. If your routine includes peptides, consider applying them at a different time. BPO can

Other Acne Treatments (Sulfur, Resorcinol)

Combining BPO with other acne treatments like sulfur and resorcinol can lead to excessive dryness, irritation, and redness.

For Each Skin Concern

Mild to Moderate Acne

Benzoyl peroxide works well for mild, and moderate acne. It's effective at killing acne-causing bacteria, clearing out sebum inside pores, and calming down redness. For this reason, its especially good for oily, and oily & dry skin.

Severe Acne

Oral antibiotics, or retinoids such as retinol, or tretinol can be often effective with BPO. This combination works effectively especially for those with severe acne.

Inflammatory Acne

We recommend you to start BPO at the low concentration. It helps calm down redness, and kills P. acne bacteria. Watch your skin if it handles well with each concentration, and gradually increase it.

Preventive Care

Benzoyl peroxide can be used as a preventive treatment to prevent any acne formations. It helps prevent breakouts by keeping the skin free of acne-causing bacteria

Body Acne

Acne is not limited on face, it can happen anywhere on the body. BPO is effective both on face, and body. It keeps both body, and face skins clear by interfering acne-forming bacteria from growing. However, moderation is the key.

For Each Skin Type

Oily Skin

Embrace: Oily skin may benefit extensively from BPO as it eliminates acne-forming bacteria, while addressing the oiliness.
Avoid: We recommend that you use BPO with low concentrations, as it can potentially cause dryness on skin or interfere with dry skin. Consider applying it every other day to prevent it.

Combination Skin

Embrace: You may get a good result using benzoyl peroxide on oily parts like the T-zone where breakouts often happen. Put BPO on those oily spots to keep them free from acne without drying out the rest of your skin.
Avoid: To prevent skin irritation, apply benzoyl peroxide only to areas that are dry. Also consider using a moisturizer. This can protect your skin's covering while you deal with pimples.

Dry Skin

Embrace: With caution, start with low concentrations (2.5% or less) and always combine it with a moisturizer.
Avoid: If it use make skin feel bad or make skin dry lots, maybe think again about use it. There other choices if benzoyl peroxide make skin too dry.

Sensitive Skin

Embrace: Very cautiously, test a small area first and consider using formulations designed for sensitive skin.
Avoid: High concentrations. Look for benzoyl peroxide products that are specifically formulated to minimize irritation, such as those combined with soothing ingredients.

Normal Skin

Embrace: Generally well-tolerated for occasional breakouts or as part of a preventative acne regimen.
Avoid: Overuse. It can disrupt the skin's natural balance such as its barrier functions, and neutralizing pH levels. This often cause dryness, or sensitivility.

Tips

Start with a Low Concentration: If you're new to benzoyl peroxide, start with the lowest concentration available (often around 2.5%) to see how your skin reacts. If your skin seems to tolerate it, you can then work your way up to stronger treatments if necessary.
Apply to Clean, Dry Skin: Cleanse your skin thoroughly, and pat it before applying BPO. Water often dilutes BPO, which significantly decrease its effectiveness.
Use a Pea-Sized Amount: Applying too much can interface with skin barrier functions, or pH levels. This leads to irritations, or redness.
Spot Treatment or Full Face Application: Depending on the severity of acne, you can apply directly on it, or as a full face applier. BPO can be used partly, or fully on your face.
Moisturize: BPO can be drying especially for dry, sensitive skin. Always seal your skin with a non-comedogenic moisturizer.
Apply Sunscreen: Sunscreen is a must if you are on BPO. Even though effective at acne, and breaking it down, it interferes severely with skin barrier, which makes the sunlight penetrate into the skin more easily.
Be Patient: Consistency is the key to achieving best results, and getting rid of stubborn acne with BPO.
Use as Directed: Don't overuse it. BPO can be very harsh on your skin environment, and overuse can cause excessive dryness, irritation, and even peeling of your skin.
Protect Fabrics: BPO is known to bleach hair, or fabrics. Use white towels, and pillowcases, and wait for BPO to completely dry out after application.
Monitor Your Skin's Response: Severe dryness, scaling, or even redness can be addressed with a frequency of application. However, if a small tint of BPO makes the skin irritated, stop using it, and consult a dermatologist for any possible skin issues.
Integrate with Other Acne Treatments Carefully: You should be careful about combining BPO with other topical ingredients, especially with exfoliants. Mild ingredients such as niacinamide, cermiades, or hyaluronic acid can be beneficial.

Alternatives

Alternative Ingredient	Skin Type	Skin Concern	Benefits
Salicylic Acid	Oily, Combination	Acne, Blackheads	Unclogs pores, reduces inflammation, and promotes exfoliation.
Sulfur	All, particularly Sensitive	Acne, Rosacea	Has antibacterial properties, reduces oiliness, and helps unclog pores.
Tea Tree Oil	All, particularly Sensitive	Mild to Moderate Acne	Natural antimicrobial and anti-inflammatory properties, good for sensitive skin.
Azelaic Acid	All, particularly Sensitive	Acne, Rosacea, Pigmentation	Reduces inflammation, kills bacteria, and helps to fade post-acne marks.
Niacinamide	All	Acne, Sebum Production, Pigmentation	Reduces inflammation, regulates oil production, and improves skin barrier function.
Alpha Hydroxy Acids (AHAs)	Dry, Sun-damaged	Acne, Fine Lines, Uneven Skin Tone	Promotes cell turnover, exfoliates the surface for smoother skin, and improves skin texture.
Beta Hydroxy Acids (BHAs)	Oily, Combination	Acne, Large Pores	Similar to AHAs but more oil-soluble, penetrating deeper into pores to remove dead skin cells.

Incorporating to Your Routine

Morning Routine

Gentle Cleanser: Start with a mild cleanser for overnight oils and slowly rub it for benzoyl peroxide application.
Benzoyl Peroxide Treatment: Apply a thin layer of benzoyl peroxide (start with a low concentration for your morning routine, e.g., 2.5% to 5%) to oily areas. Allow it to fully dry out on the skin.
Moisturizer: Follow up with a non-comedogenic moisturizer to hydrate your skin to address dryness from the application of BPO.
Sunscreen: A broad sunscreen is necessary to prevent side effects from BPO. BPO interferes skin barrier, and makes the UVB, and UVA penetrate more inside the skin.

Night Routine

Gentle Cleanser: Use a mild cleanser that doesn't interfere your skin's pH levels. However, it's important to remove the makeup, sunscreen, or oils on your skin before applying BPO.
Benzoyl Peroxide Treatment: Apply BPO to the oily, acne-prone, or acne areas with a higher concentration if your skin tolerates it well. Allow it dry completely on skin.
Hydrating Moisturizer: Use a rich, lightweight moisturizer that doesn't clog pores in the evening. This is necessary to hydrate your skin deeply, and recover its functions overnight. Look for products with ceramides or hyaluronic acid.
Spot Treatment (Optional): If you have areas that require extra care, you can apply BPO directly to the spots as a treatment instead of a full-face BPO application.